Whole Plant Foods and Hypertension

Abstract

Whole (and minimally processed) plant foods usually contain some mixture of blood pressure (BP) lowering bioactive nutrients and phytochemicals such as dietary fiber, potassium, magnesium, carotenoids, polyphenols, unsaturated fat, and plant protein and are lower in sodium and sugar compared to highly processed plant foods. Whole plant foods are more effective at reducing BP in adults who are ≥45 years, hypertensive and obese than adults <45 years, normotensive, or lean. Prospective studies show that the consumption of healthy diet with ≥3 daily servings of whole grains, especially oats and barley rich in β-glucan, and ≥5 daily servings of fruits and vegetables, especially when including ≥4 weekly servings of broccoli, carrots, tofu or soybeans, raisins, grapes and apples, are associated with lower hypertension risk compared to Western diets. RCTs support the effectiveness of whole grains in lowering BP, especially at 50 g/1000 kcals or those rich in β-glucan; fruits and vegetables rich in polyphenols or nitrates and their 100% juices have been found to lower systolic BP; and two daily servings of dietary pulses or 40 g soy protein are effective in lowering BP. Flaxseeds and sesame seeds tend to be more effective than nuts in lowering BP. Tea and coffee have different effects on BP. Both black and green tea (>2 cups/d) modestly lower BP in hypertensive individuals. Coffee (>3 cups/d) does not increase hypertension risk in normotensive people but hypertensive individuals may be more sensitive to acute increases in BP after coffee consumption. The potential mechanisms by which whole plant foods may reduce blood pressure and hypertension risk are; reducing the risk of weight gain, enhancing insulin sensitivity, improving vascular endothelial function, slowing the rate of arterial plaque build-up, maintaining electrolyte balance, and stimulating a healthier microbiota ecosystem.